ATHENS GYNECOLOGY PC (NPI# 1215132527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215132527 |
| Entity Type | Organization |
| Organization Name | ATHENS GYNECOLOGY PC |
| Other Organization Name | EASTSIDE GYNECOLOGY |
| Practice Address |
1270 Prince Avenue Suite 202 Athens GA 30606 |
| Mailing Address |
1580 Tree Ln Po Box 325 Snellville GA 30078-2207 |
| Practice Telephone | 7065484424 |
| Practice Fax Number | 7065484880 |
| Mailing Telephone | 7709787246 |
| Mailing Fax Number | 7709798348 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2008-04-24 |
| Authorized Official Name | DR. ROBERT EARL KELLEY JR. (PHYSICIAN PRESIDENT) |
| Authorized Official Telephone | 7065484424 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000084763B | 05 |
| Other Name | Type Code |
|---|---|
| Eastside Gynecology | Doing Business As Name - Organization |
| Street Address |
1270 PRINCE AVENUE SUITE 202 |
| City | ATHENS |
| State | GA |
| Zip Code | 30606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003470311 | Nicola Natasha Jackson | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue, Suite 201, Athens, GA 30606 | 2019-04-23 |
| 1356830632 | Shion Antonio Betty | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue, Suite 201, Athens, GA 30606 | 2018-05-02 |
| 1861687063 | Jessica Veann Swilley | Nurse Practitioner | 1270 Prince Avenue, Suite 308, Athens, GA 30306 | 2007-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816962 | Kofi Darkwa Seffah | Student in an Organized Health Care Education/Training Program | 1199 Prince Ave #70, 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-09-16 |
| 1831712363 | Rebecca John | Licensed Practical Nurse | 240 Mitchel Bridge Road, Athens, GA 30606 | 2020-05-19 |
| 1497375612 | Alfred Ka-shing Wong | Student in an Organized Health Care Education/Training Program | 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-04-17 |
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1255981700 | Carol Cameron Cready-pyle | Social Worker | 1551 Jennings Mill Pkwy Ste 1700, Athens, GA 30606 | 2019-09-17 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1760045223 | Dominic Ofosu Amakye | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue Suite 201, Athens, GA 30606 | 2019-04-19 |
| 1740740422 | Juan G Salazar Castillo | Student in an Organized Health Care Education/Training Program | Community Internal Medicine of Athens, 1500 Oglethorpe Ave Suite 200d, Athens, GA 30606 | 2019-03-20 |
| 1750869020 | Jennifer Emily Chapman | Physical Therapist | 1021 Parkway Blvd Ste 101, Athens, GA 30606 | 2018-07-30 |
| Find all providers in zip 30606 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891703849 | Athens North Alabama Womens Health | Obstetrics & Gynecology | 1005 W Market St Ste 7, Athens, AL 35611 | 2006-08-04 |
| 1205825205 | Gregory Doyle Perry | Obstetrics & Gynecology | 1270 Prince Ave, Suite 201, Athens, GA 30606-2762 | 2005-10-21 |
| 1558634386 | William J Hardman | Obstetrics & Gynecology | 740 Prince Ave Ste 3, Athens, GA 30606-5903 | 2012-02-09 |
| 1205124492 | Thompson Gynecology PC | Obstetrics & Gynecology | 195 King Ave, Athens, GA 30606-6736 | 2011-07-21 |
| 1912185513 | Valley Obstetrics & Gynecology PC | Obstetrics & Gynecology | 725 W Market St, Suite B, Athens, AL 35611-2456 | 2008-02-06 |
| 1053531954 | Cassie Nicol Campbell | Obstetrics & Gynecology | 1199 Prince Ave, Athens, GA 30606-2797 | 2007-04-26 |
| 1467442327 | James Leon Smith | Obstetrics & Gynecology | 1270 Prince Ave, Suite 201, Athens, GA 30606-2762 | 2005-10-24 |
| 1639168644 | Cary Cunningham Perry | Obstetrics & Gynecology | 1270 Prince Ave, Suite 201, Athens, GA 30606-2762 | 2005-10-21 |
| 1124017116 | Cynthia Ann Mercer | Obstetrics & Gynecology | 1270 Prince Ave, Suite 201, Athens, GA 30606-2762 | 2005-10-21 |
| 1083603005 | Athens Women's Clinic, LLP | Obstetrics & Gynecology | 1270 Prince Ave, Suite 201, Athens, GA 30606-2762 | 2005-10-21 |
| Find all providers in ATHENS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.